Refractory Heparin-Induced Thrombocytopenia With Cerebral Venous Sinus Thrombosis Treated With IVIg, Steroids, and a Combination of Anticoagulants: A Case Report
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Gonzales, Mia
Pipalia, Amrish
Weil, Andrew
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Abstract
Heparin-induced thrombocytopenia (HIT) type II is caused by antibody production that bind complexes between heparin
and platelet factor 4 leading to platelet consumption and thrombosis. In a small subset of cases referred to as autoimmune
HIT, the antibodies activate platelets even in the absence of heparin. Refractory HIT is a type of autoimmune HIT in which
thrombocytopenia persists for weeks after heparin discontinuation and carries increased risk for thrombosis and more
severe thrombocytopenia. We present a case of refractory HIT with cerebral venous sinus thrombosis (CVST) that was
successfully treated with a change in anticoagulant alongside steroids and a second trial of intravenous immunoglobulin
(IVIg).
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10.1177/2324709619832324